OTTAWA—North America’s lone supervised needle injection site Vancouver won a constitutional reprieve from the country’s top court, which blasted the Conservative government for its “arbitrary” and moralistic approach.

In a decision that sharply pits the court’s view of a coherent drug strategy against the Conservative government’s, the Supreme Court of Canada ruled 9-0 the health minister cannot deny a legal protection to addicts and clinical health workers who would otherwise be penalized by federal drug laws.

Faced with overwhelming evidence that medical supervision of injections curbs infections and saves lives, the court granted the InSite clinic, open since 2003, an immediate exemption under the federal drug law to allow it to continue to operate.

It potentially opens the door to the establishment of new clinics elsewhere in the country, though the court said there must be solid evidence to support them.

The judges admonished the federal government, saying that in future the power to grant exemptions for reasons of “medical, scientific or public interest” must be exercised “within the constraints imposed by the law and the Charter, aiming to strike the appropriate balance between public health and public safety.”

Health Minister Leona Aglukkaq told the Commons the government would “comply” with the ruling.

Asked to acknowledge the court’s finding that InSite saves lives, Aglukkaq retorted that “drugs kill people, too” — a comment not recorded in the official transcript, but later acknowledged by her office.

Prime Minister Stephen Harper in Quebec City said he was “disappointed” by the ruling, hailed by health workers, addicts and the Opposition as a huge “victory.”

But Harper made clear his view is unchanged.

“The preference of this government in dealing with drug crime is obviously to prosecute those who sell drugs and create drug addiction in our population and our youth, and when it comes to treating drug addiction, to do so through programs rather than though the issues in front of this court in terms of the so-called harm reduction. We’ll look at the decision, respect the decision and work within the decision.”

“These sites are evidence that health authorities are increasingly recognizing that health care for injection drug users cannot amount to a stark choice between abstinence and forgoing health services. Successful treatment requires acknowledgment of the difficulties of reaching a marginalized population with complex mental, physical and emotional health issues.”

The high court said Ottawa’s federal drug law is a valid exercise of its criminal-lawmaking power. But the Conservatives flexed their muscle in an “arbitrary” and “grossly disproportionate” way.

The judges said InSite has not had a negative impact on public safety or public health. Drug trafficking and crime in downtown Vancouver hadn’t increased, nor had relapses by drug addicts, while lives had been saved.

Backed by local police, the municipality and provincial government, the supervised safe injection site “was the result of years of research, planning and intergovernmental cooperation” and a model of “cooperative federalism,” the court concluded.

The judgment means InSite will continue to provide clean water and equipment to drug users, along with nurses who supervise heroin addicts who bring their own illegally obtained drugs and come to shoot up safely. Addicts can get counselling and detoxification treatment on the second floor at another clinic called OnSite.

Dean Wilson, a 55-year-old now-sober addict who helped launch the court challenge in 2008, could hardly believe his ears.

“Guys, we did it,” he cheered, pumping his arm in the air as cameras streamed reaction live from the court to the Downtown Eastside.

Wilson, whose addiction is still being treated with methadone, urged the Conservatives to drop their “ideological bent” and work to “make sure that this kind of gold-standard medicine can be facilitated across the country.”

Advocates in Montreal and Toronto have lobbied for other sites, though no formal proposals are currently before the federal government. Dr. Julio Montaner said in Vancouver, “We don’t know how many we need, but certainly many are needed” across the country.

Dr. John Haggie, president of the Canadian Medical Association, said: “There may be a really good case” for clinics in those cities, but supervised injections are for the seriously ill.

“We would like to see it as part of a national strategy that involved prevention, treatment, harm reduction and enforcement.”

Haggie said flatly the Conservative strategy has not worked, but British Columbia’s approach does. “This has made a difference. People are no longer dying in Downtown Eastside.”

The Supreme Court did not give a free pass to anyone to set up a safe-needle injection site, saying there must be solid evidence to support it. The ruling said if circumstances at InSite change, it could lose its exemption.

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